San Antonio Express-News (Sunday)
WHAT TO WATCH
From the publishers of TV Guide
Expedition Bigfoot
discovery+
Strange, unmarked helicopters fly overhead as Russell Acord, Ronny LeBlanc and Mireya Mayor try to make sense of abnormal thermal images they captured near a river. Bryce Johnson reaches out to former federal agent Ben Hansen to get to the bottom of the suspicious activity.
In Pursuit: The Missing
discovery+
This hourlong special highlights victims advocate Callahan Walsh’s personal experience with tragedy while he investigates two mysterious disappearances and showcases additional unsolved missing persons cases from around the country.
The 26th Annual Critics Choice Awards
The CW, 6 p.m.
Hosted by Taye Diggs, this ceremony will honor the finest achievements in film and television in 2020. This year’s film nominees are led by Netflix’s “Mank,” which earned 12 nominations. Netflix also leads the pack in the television category, with its series “Ozark” and “The Crown” with six nominations each.
Bless the Harts
Fox, 6:30 p.m.
Jenny (voice of Kristen Wiig) takes over as Mayor Webb’s (guest voice of Jon
Hamm) campaign manager for re-election against Betty (voice of Maya Rudolph) and an accomplished dog in the new episode “The Dogchurian Candidate.”
Oprah With Meghan and Harry
CBS, 7 p.m.
Oprah Winfrey sits down with Prince Harry and Meghan, the Duke and Duchess of Sussex, for an intimate conversation in this exclusive prime-time special.
The Simpsons
Fox, 7 p.m.
In the new episode “Yokel Hero,” Cletus (voice of Hank Azaria) becomes a singing sensation, but he ruins everything when he turns on his fans.
The Walking Dead
AMC, 8 p.m.
Daryl (Norman Reedus) and Carol (Melissa McBride) find an old cabin that takes Daryl back to his years away from the group after Rick disappeared. He relives the painful memory of meeting a reticent survivor and the toxic events that amplified his relationship with Dog.
Men in Kilts
Starz, 8 p.m. “Outlander” stars Graham McTavish and Sam Heughan continue roadtripping through their native Scotland with stops at sites linked to witchcraft and superstition.
Good Girls
NBC, 9 p.m.
The comedy/drama returns for season four. Stakes get higher for Beth (Christina Hendricks), Ruby (Retta) and Annie (Mae Whitman) as the Secret Service closes in on the women’s counterfeit ring.
Q: I am a 77-year-old man in good health. I was diagnosed with Crohn’s disease about 15 years ago, but had no symptoms. Recently I had a colonoscopy after blood was found in my stool. A biopsy confirmed Crohn’s disease, and a follow-up CT scan showed a stricture in the terminal ileum. My doctor prescribed Humira, but I am concerned about the possible side effects. With no symptoms, I wonder whether I really need it.
A: Management of Crohn’s disease is complicated, and there is no substitute for experienced clinical judgment, so I asked my colleague Dr. Sunanda Kane at the Mayo Clinic. She advised me that many people who say they have no symptoms “subconsciously changed their diet or other habits based on early satiety, bloating or a sense of fullness.”
Dr. Kane noted also that strictures can be due to inflammation or fibrosis. If the stricture they found was inflammatory, she says, “Humira is a good therapy and the risk is worth the benefits. If this is a fibrostenotic stricture then we recommend a low residue diet and monitoring for complications like anemia or vitamin deficiencies. A dedicated CT enterography can discern between an inflammatory and fibrostenotic stricture. Some people have an element of both, and Humira is good for the inflammation portion. In this era of COVID we try to stay away from steroids and absolutely want to treat active inflammation, as this appears to be a risk factor for contracting COVID and more complicated infection.”
Q: Twenty-five years ago I had a gallstone stuck in my pancreas, causing severe pancreatitis. My gallbladder was removed. I haven’t had an attack since. I was taking Pravachol at the time, but was taken off of it. At 78, my triglycerides are borderline high. Is there a statin I could take that would not cause stones or affect my pancreas?
A: Gallstones are made of a combination of cholesterol and bile salts. If one gets stuck in the bile duct, it may cause inflammation of the gallbladder (acute cholecystitis), but it may also get stuck in
the common bile duct, causing cholecystitis and pancreatitis, since it will block the outflow of the pancreas as well.
Some drugs can predispose a person to getting gallstones, including the cholesterol-lowering class of drugs called fibrates. People who regularly take statin drugs like pravastatin (Pravachol) have a decreased risk of gallstones. The risk in a person taking a statin is roughly 1⁄3 less than a person not taking one: not enough to protect all attacks, but certainly not a reason to stop taking a
statin.
Borderline high triglycerides may not, by itself, be enough of a reason to start a statin, so discuss all the pros and cons of a statin with your doctor, but gallstone risk is likely to be helped, not worsened, by statin treatment.
Q: In your recent column about the COVID-19 vaccine, you review the Pfizer vaccine results along with your suggested approach. You say: “People with a history of COVID-19 infection benefited from the vaccine just as much as those
without, suggesting no natural immunity was present.” I’m curious what specific results from the study led you to this conclusion. Thank you!
A: There is some degree of immunity after natural COVID-19 infection for at least the first three months after infection. After that, immunity begins to wane.
In the large study for the Pfizer vaccine, longerterm immunity was evaluated by comparing the risk of acquiring COVID-19 (in the group that did not receive vaccine) among those who had antibodies showing previous infection
against those who did not. The “attack rate” (the proportion infected by COVID-19) was 1.3 percent in people with and without COVID-19 antibodies at baseline.
The numbers were small: Only 3 percent of participants had evidence of prior infection at study enrollment, and additional analyses showed that very few COVID-19 cases occurred in these participants over the course of the entire study. The placebo group’s attack rate from enrollment to the end of the study was 1.3 percent, both for participants without evidence of prior infection at enrollment (259 cases in 19,818 participants) and for participants with evidence of prior infection at enrollment (nine cases in 670 participants). While limited, these data do suggest that previously infected individuals can be at risk of COVID-19 (i.e., reinfection) and could benefit from vaccination.
Q: My son contracted encephalitis at age 7 months in 1963. He had no upper respiratory symptoms; he fell asleep and then developed high fever, which left him deaf and with expressive aphasia. We never understood what happened. I recently read an article about a correlation between herpes simplex and encephalitis. My husband had many episodes of cold sores. We wonder if that could have been the source of infection. It doesn’t help my son, but it could be a warning to other parents not to let people kiss their babies. What do you think?
A: It’s been nearly 60 years, but I am still sorry for what happened. Seeing a child become disabled is an extraordinarily difficult thing for a parent, and raising a disabled child is a challenge for any family.
There are many causes of encephalitis, and most can potentially lead to neurological disease, including deafness and aphasia. While herpes simplex viruses are a common cause, there are many viruses, bacteria and even parasites and fungi that could have been the cause. Since this was 1963, diseases that are (nearly) eliminated now, such as measles and rubella, would be common causes, though the vast majority of those have characteristic skin findings that no doctor in 1963 would have missed (many doctors now have never seen a case).
The incidence of encephalitis in children is quite low, less than 1 in 10,000. Only a small percentage of those will be due to herpes simplex virus. I wouldn’t advise parents in general to avoid kissing their children; however, it’s a good idea not to do so when a parent is having an outbreak of oral herpes (cold sores).
Dr. Roach regrets that he is unable to answer individual letters, but he will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med. cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.